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WASH FACTS

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Global
• Approximately 50 liters of water per person per day is needed to ensure that most basic needs are met while keeping public health risks at a low level (WHO, 2017).
• 785 million people worldwide lack access to basic drinking water services. Among them, 144 million still collect drinking water directly from rivers, lakes and other surface water sources (UNICEF, 2019).
• 207 million people worldwide spent over 30 minutes per round trip to collect water from an improved source (WHO/UNICEF, 2019).
• Women and girls are responsible for water collection in 80% of households without access to water on-premises (United Nations, nd).
• Globally, at least 2 billion people use a drinking water source contaminated with feces (WHO, 2019).
• 2 billion people worldwide lack access to a basic sanitation (toilet) service. Among them, 673 million people still practice open defecation, and a majority are in Southern Asia (UNICEF, 2019). This practice puts women, children, and their communities at risk. Open defecation is an easy pathway toward diarrhea and related infections. Women and girls are particularly vulnerable to sexual assault when they go to defecate in an unprotected place (Shongen, 2017).
• 1 in 5 girls of primary school age is not in school, compared to 1 in 6 boys. An important factor accounting for this difference is the lack of sanitation facilities for girls reaching puberty. Girls are also more likely to be responsible for collecting water for their families, making it difficult for them to attend school during school hours. The installation of toilets and latrines may enable school children, especially menstruating girls, to further their education by remaining in the school system (UNICEF, 2005).
• 1 in 4 persons worldwide does not have access to a handwashing facility with soap and water on-premises and only 26% of potential fecal contacts are followed by handwashing with soap (Wolf et al., 2018).
• In the Least Developed Countries, 27% of the population has basic handwashing facilities with soap and water, while 26% have handwashing facilities lacking soap or water. The remaining 47% have no facility for handwashing (WHO/UNICEF, 2019).
• In low- and middle-income countries, 50% of health care facilities (HCFs) lack piped water, 33% lack improved sanitation, 39% lack handwashing soap, and 39% lack adequate infectious waste disposal (USAID, 2018).
• Every year, there are nearly 1.7 billion cases of diarrheal disease, and up to 432, 000 diarrheal deaths occur from poor sanitation. It is also linked to the transmission of other diseases such as cholera, dysentery, typhoid, hepatitis A and few other neglected tropical diseases including intestinal worms, schistosomiasis, and trachoma. Poor sanitation also contributes to malnutrition (WHO, 2019).
• Some 297,000 children – more than 800 every day – under five die annually from diarrheal diseases due to poor sanitation, poor hygiene, or unsafe drinking water (WHO, 2019).
• Globally, diarrhea, pneumonia, sepsis, and other WASH-related infections account for an estimated 33% of deaths among children under the age of five (Cronk, 2018).
• Trachoma is the world’s leading cause of preventable blindness and results from poor hygiene and sanitation. Approximately 142 million people live in trachoma endemic areas with a high risk of trachoma blindness and nearly 1.9 million people are visually impaired or irreversibly blind as a result of trachoma (WHO, 2020).
• Loss of productivity to water and sanitation-related diseases costs developing countries in average 5% of their GDP (WHO, 2012). The World Bank estimated that as much as 6.4% of India’s GDP is lost to adverse economic impacts and costs of inadequate sanitation (United Nations, 2016).
• Improved water sources reduce diarrhea morbidity by 21%; improved sanitation reduces diarrhea morbidity by 37.5%; and the simple act of handwashing at critical times can reduce the number of diarrhea cases by as much as 35% (UNDP, 2005).
• Universal access to safe drinking water and adequate sanitation and hygiene would prevent at least 9.1% of the global disease burden and 6.3% of all deaths (WHO, 2008).
• Water and sanitation interventions are cost-effective across all world regions. These interventions demonstrate to produce economic benefits ranging from US$ 5 to US$ 46 per US$ 1 invested (Hutton et al., 2007).
• In urban areas, for every $1 invested in basic drinking water, more than $3 is returned in saved medical costs and increased productivity. For every $1 invested in basic sanitation, the return is $2.5. In rural areas, the return on investment is even higher: with every $1 invested in basic drinking water, nearly $7 is returned in saved medical costs and increased productivity. And, in the case of basic sanitation in rural areas, every $1 return on average $5 in saved medical costs and increased productivity (Hutton et al., 2015).
• Funding for WASH must triple to US$114 billion each year to meet SDG Goal 6 targets for water, sanitation and hygiene (WHO, 2017).

National
• Nepal is endowed with abundant water resources from an availability point of view (WECS, 2011). Despite occupying less than 0.04% of the world’s total land area, it possesses 2.7% of the available freshwater on earth (ADBI, 2019). However, the country’s harsh terrain makes access to water supply difficult for many segments of the population.
• 88% of the country’s population now has access to basic drinking water services and about 20% have access to medium and high-level services (NPC, 2018).
• The coverage for urban water supply now stands at 96% (UNICEF, 2016).
• Disparity in the water supply can be observed among the seven Provinces of the country. It is lowest for Karnali Province (70.45%) while the highest for Bagmati Province (91.01%) (Budhathoki, 2019).
• 49.5% of households have access to piped water supply (MWSS, 2016).
• The functional status of existing water schemes remains poor. Only 25% of the country’s water schemes are reported to be fully functioning, while 36% require minor repairs, and 39% need major repair, rehabilitation, or reconstruction (UNICEF, 2016).
• Water quality remains a priority concern given the vulnerability of existing systems to contamination and inadequate water treatment practices. 71% of all water sources and 91% of those used by the most deprived quintile are contaminated with E. Coli (Escherichia coli) bacteria – a major cause of diarrhea (UNICEF, 2016).
• Arsenic (As) and heavy metal contamination of groundwater have assumed alarming proportions in the southern plains of the country (Shrestha, 2017).
• Of the supplied water, 34% is reported to be safe for drinking, and a meager 15% meet the national water quality standards (WHO/UNICEF, 2019).
• Nationally, 7% of households spent 30 minutes or longer collecting water. However, the regional disparity remains high. For instance, some 30% of households in the mid-western hills and mountains, 29% in the far-western hills and 19% in the Far Western mountains spend more than 30 minutes collecting water (UNICEF, 2016).
• In addition to losing productive opportunities and forgoing education to the routine task of water collection, women and children suffer greatly from waterborne diseases and the high cost of health care. Children under five are affected the most, with an estimated 3,500 children in the country dying annually from waterborne diseases (Aryal, 2012).
• Since the inception of the National Sanitation and Hygiene Master Plan 2011, sanitation coverage accelerated by an average of 7% per annum (compared with an average of 4% per annum over the previous decade) (WSCC, 2019).
• Hovering between 2% and 6% in the 1980s and 1990s, the percentage of people with access to basic sanitation accelerated to over 99% by mid-2019. On 30 September 2019, the Government of Nepal declared the country ‘open defecation free’ (ODF) and is rapidly scaling-up access to safely managed sanitation services as the next priority (WSCC, 2019).
• 78% of the country’s schools have water supply facilities, and 82% have a toilet (UNICEF, 2016).
• Although water and sanitation coverage has been improving in schools, critical bottlenecks remain, particularly as they relate to girls and children with disabilities. 15% of community schools lack separate toilets for boys and girls, and MHM facilities for girls (UNICEF, 2016).
• The involvement of users in the process of planning and implementation significantly increased from 6% (1990) to 87.3% (2016) in sanitation and 46% (1990) to 87% (2016) in the water supply (MWSS, 2016).
• Building on the success of the Millennium Development Goals, Nepal is committed to pursuing and achieving the Sustainable Development Goals (SDGs) by 2030. It has set specific targets in SDG 6 that include basic water supply coverage to 99% households, piped water supply and improved sanitation to 95% of households along with total elimination of open defecation by 2030 (NPC, 2018).
• The water and sanitation-related targets in SDG-6 are inherent in the country’s periodic development plans and guided by the Nepal WASH Sector Development Plan (SDP) 2016-2030 (WSCC, 2019).
• The cost per person served with improved sanitation and hygiene services in Nepal ranges from US$ 8 – 10 (OPM, 2016).
• The economic returns on water and sanitation investments are around 3.5 for water supply, 6.9 for sanitation, and 6.6 for fully integrated projects (MOUD, 2014).
• The annual government expenditure on WASH is around 3% of the national budget, with a funding gap of NPR 30 billion (approx. US$ 280 million) to meet the current needs (WaterAid Nepal, 2018).